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Ask the Kit: Should I use a menstrual cup?

I’ve been hearing about menstrual cups at lot lately, mostly the Diva Cup. They kind of freak me out, but do they work? Should I try one? Will it be weird? — Francesca, Toronto

It’s almost a new decade, so now is probably a good time to rid ourselves of whatever bad habits we have lurking. My suggestion of what to jettison? The impulse to whisper “gross!” when it comes to menstrual biz of any kind. I get it, menstruating may be a blessing, but it often feels like a curse. Since many of us are going to menstruate on the regular for roughly 40 years, though, instead of cringing, let’s invest our energy looking objectively at what our options are.

With that in mind, I called Dr. Courtney Howard, a physician now based in Yellowknife and president of the Canadian Association of Physicians for the Environment, who conducted the first randomized controlled study comparing tampons to menstrual cups in 2006. “A patient came into my office years ago and asked me this exact question,” she explains “As a doctor, when a patient asks you a question, you look it up — and there wasn't any information.” So Howard “fell down an internet rabbit hole” looking for data to empower her patient and came up terrifyingly empty. The only fact that was confirmed? “Women's health is under-researched compared to men's health.”

The menstrual cup has been around in several incarnations, enjoying varying degrees of popularity, since early in the century. The current style of cup is formed out of medical-grade silicone and inserted into the vagina to collect menstrual fluid; however, there is a “serious knowledge gap” about its pros and cons.

So Howard carried out a study with a team of fellow residents, revealing a few very interesting findings: First, in general, the women surveyed were more satisfied with the cup than with tampons. “One of the reasons they gave was that they didn't have any leakage and there wasn't any odour,” explains Howard. These are good pros. Also nine out of 10 women planned to keep using a cup and would tell a friend about it.

It’s critical to acknowledge that we have choices when it comes to how we manage our periods — choices that go beyond simply doing what we were doing at 13. (Imagine you were still wearing the same style of jean or crushing on the same kind of person? Horror.)

The reality is that the burden of our choices extends beyond our bodies, too: The environmental impact of our monthly flow has been flowing into landfills and piling up on beaches. In North America alone, it’s estimated that about 20 billion sanitary napkins, tampons and applicators are dumped into landfills every year. And, during a beach cleanup at Turtle Grove in Dartmouth, N.S., in 2018, volunteers found 381 plastic tampon applicators in a 150-metre stretch of shoreline.

The good news is that there’s a pretty simple fix: Menstrual cups, which are reusable for years on end, eliminate a great deal of that waste. They also cut down on the amount you have to shell out every month for a box of tampons, which is especially useful for the 33 per cent of Canadian women under 25 who have struggled to afford menstrual products, according to a 2018 survey by Plan Canada — and also handy for those of us who don’t like literally flushing money down the toilet (or cramming it into those tiny little public bathroom garbage cans).

So that’s the big-picture view of your choice. But there are other factors, of course, since this is a very intimate act. “For most women, the most comfortable progression is probably going from tampons to cups, rather than from pads, because it’s good to have a certain amount of comfort with vaginal touching and your anatomy,” says Howard.

Her study determined, quite sensibly, that women’s confidence was easily bolstered by simply talking through the process of using a cup. So here’s what you need to know: There are at least two sizes of cup, one for young women who have not had a baby, and another for the rest of us. (Some brands offer a couple of sizes in between.) Your silicone cup of choice is inserted into your vagina using your fingers and then forms a semi-vacuum seal to keep you dry, although I like wearing leak-proof underwear as well because I have a Scout’s attitude toward my period. Then, up to 12 hours later, you simply remove it, rinse it clean and reinsert. Admittedly, there are a few gritty realities in this seemingly simple process. As my Friend and former Kit editor Jennifer Berry so eloquently said: “Like the first time you locked eyes with a menstrual-blood-soaked tampon, a Texas shot glass’s worth of uterine lining isn’t the most pleasant to look at, but you get used to it.” Truer words, my friend. It took me about three months, but I am now unfazed.

The other fine point is that you don’t simply pull out a cup as you would a tampon. “The best way to remove it is to sneak a finger up along the side of the cup until the tip of your finger is around the rim at the top and then you push in to release the vacuum seal,” explains Howard. With that in mind, once you’re a pro at the process, feel free to trim the little tip that is intended to help you grip the cup. Some women, she says, find it causes irritation, and if you’re removing the cup as she suggests, you really don’t need it.

If you need to empty the cup while you’re out, one brand of product states that you can simply wipe it down and reinsert it until you have enough privacy to rinse it carefully. Dr. Howard offers an even simpler approach: Just look for a one-person or accessible bathroom that has a sink.

My advice? Try it. I don’t miss the feeling of realizing your last tampon just got squashed in your purse and you’re now in survival mode. “Being a young woman is hard enough,” agrees Howard with a laugh. “The more information we have, the more able we are to confidently live healthy lives.”

Kathryn Hudson is the editor-at-large of The Kit. She writes about style and culture and answers reader questions for our weekly Ask The Kit column. Reach her on email at kh@thekit.ca or follow her on Twitter: @KathrynHudson

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